Neuroethics has become a much discussed topic in the last years due to the new and, in some cases, unique ethical challenges that new advances in neuroscience and neurotechnologies present us with. However, a theoretical perspective highlighting the importance of improving care for those suffering from neurological and psychiatric disorders has been neglected. Eric Racine takes the challenge to develop such a perspective in his book Pragmatic Neuroethics: Improving Treatment and Understanding of the Mind-Brain.

This book, which has an accessible style, is a an important contribution to neuroethics, since it provides a good review of the different and divergent perspectives within neuroethics, and stresses the importance of a perspective on neuroethics that encourages reflection, action, and research towards meeting the day-to-day suffering and distress that different neuro-related disorders bring for individuals and society in general.

The book is divided into two parts. The first section is the theoretical part in which the author provides background on neuroethics and pragmatism. In this first part Racine also introduces the view he endorses, namely pragmatic neuroethics. The second part of the book is a more empirically driven section, in which he discusses relevant topics in neuroethics using empirical data and real examples, such as, cognitive enhancement and public understanding.

The book begins with an overview of neuroethics. In this chapter Racine suggests four main areas of neuroethics scholarship and practice: research neuroethics, clinical neuroethics, public and cultural neuroethics, and theoretical and reflective neuroethics. In the second part of the chapter he highlights some of the salient challenges in modern neuroethics, such as, neuro-enhancement, informed consent, and issues related to "mind reading".

The second chapter reviews some of the early and current definitions, attributes, and perspectives on neuroethics. He distinguished three main ways to characterized neuroethics according to its particular perspective, namely knowledge-driven, technology driven or healthcare driven. Racine also does a review of the peer review literature, web sites, and print media to undercover the most representatives attributes related to neuroethics and the main concerns discussed.

Racine moves in chapter three, to introduce and present different waves of naturalism in bioethics, focusing in particular on pragmatic naturalism for its "commitment to interdisciplinary collaborations and its practical focus" (p.53). He suggests that neuroethics as an emergent field of study has reinitiated discussion on the importance of establishing bridges between the biological sciences and the humanities. Furthermore, he argues that a moderate pragmatic form of naturalism is a better position to start debate within bioethics.

Chapter four looks at the implications of pragmatic naturalism by addressing several critiques that have been put to neuroethics, such as: introducing detrimental specialization in biomedical ethics, having a too narrow focus, and implying a reductionist approach. Racine concludes this chapter by highlighting some of the characteristics of a pragmatic neuroethics perspective, such as, being interested not only on the organ of the brain, but also for patients and the public.

Chapter five is the start of the second section of the book and it draws attention to the importance of public understanding of neuroscience innovation and emerging interpretations of neuroscience research. Racine argues that understanding better the impact of neuroscience for our own self-understanding, fostering communication, and taking multidirectional approaches to neuroethics debates is needed in order to broaden the discussion by including public concerns and not just expert's opinions.

In chapter six, Racine touches on the issue of the increasing prevalence and importance of nonmedical uses of neuropharmaceuticals by discussing the case of performance enhancement. While discussing enhancement he introduces two different concept of morality surrounding the discussion--the praiseworthy and the acceptability frameworks of morality--and argues that they should be seen as complementary to better grasp the issues involved.

Racine moves in chapter seven to discuss different disorders of consciousness, such as, vegetative state and the minimally conscious state. He first provides the background information to distinguish between the different clinical conditions, and then he uses the case of neuroimaging to show how in an evolving neuroscience context some assumptions about these disorders will be challenged.

Chapter eight takes part of the material presented in the previous chapter and uses the case of severe brain injury to take a closer look at the existing variability and confusion within the clinical and public domain about diagnosis and prognosis of disorders of consciousness.

Chapter nine talks about the ethical implications related to the impact of neuroscience on society, human behaviour, and humanity (an area also known as social neuroscience), and tackles a number of arguments that have been made against the neuroscience of ethics. In this chapter Racine also puts forward a framework, based on pragmatic thinking and emergentist philosophies of science, for addressing the controversial relationship between ethics and neuroscience.

Racine's closing chapter summarizes the main arguments of the book and emphasizes the future challenges for neuroscience, ethics, and society. Racine hopes that Pragmatic Neuroethics can at least be a good starting point to foster multidirectional approaches and to help develop practical and pluralistic approaches for neuroethics.

Pragmatic Neuroethics: Improving Treatment and Understanding of the Mind-Brain is a welcome addition to the evolving field of neuroethics as it offers us a different perspective to understand and use neuroethics. It is not only a book addressing ethical issues that have come to the fore with new advances in neuroscience, but it also highlights what is the practical and ethical importance of actively debating these issues and using the insights gained by this process to improve patient treatment as well as to gain better understanding of the mind-brain.

Laura Cabrera is a PhD research student in ethics and emergent technologies in the Centre for Applied Philosophy and Public Ethics at Charles Sturt University. Laura received a BSc in Electrical and Communication Engineering from ITESM University in Mexico City, and a MA in Applied Ethics from Linköping University in Sweden. Her current research focuses on nanotechnology and neurotechnology, human enhancement, posthumanity, and the ethical dimensions of emerging technology especially those connected to medical issues and individual/social perspectives. [email protected]

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